Group 05302 – Solar Power Purchase AgreementsPage 1 of 12

ATTACHMENT 10

MINIMUM QUALIFICATIONS SUBMITTALFORM

Bidder’s Name:
Instructions:
Please provide the information requested below in the box(es) provided. Please note that any Bidder who fails to submit responses to the questions herein may be deemed non-responsive and denied further consideration for Contract award.

SECTION 1: EXECUTIVE SUMMARY

  1. Headquarters Address –
Please provide the address of your company’s headquarters (Street, City, State, Zip):
  1. Please provide the date that your company was established, organized or incorporated (whichever occurred first):

  1. Please provide your company’s gross annual sales for the 2015 tax year:

  1. Please provide the total number of employees on your company’s payroll on 12/31/2015:

SECTION 2: MINIMUM REQUIREMENTS

See Section 3.1 in the Solicitation.

  1. Has your company maintained an organization, in continuous operation, for at least three years prior to the bid opening date?

☐ / Yes
☐ / No
  1. Does your company have at least three years of experience developing, installing and maintaining solar PV systems?

☐ / Yes
☐ / No
  1. Is your company on NYSERDA’s list of Commercial/Industrial Solar Electric (PV) Installers?

☐ / Yes
☐ / No

SECTION 2: MINIMUM REQUIREMENTS (cont’d)

See Section 3.1 in Solicitation.

References will be contacted for a performance rating as detailed in Section 5.2 Reference Check in the Solicitation).

The Bidder must provide Photovoltaic (PV) Projects that meet the requirements of Section 3.1 and the following:

  • Bidder must provide a total of tencompleted PV Projects completed in the last five years from the date of Bid opening;
  • At least one of the PV Projects Bidder listsmust have a size equal to or greater than the‘Minimum PV Project Size’ listed in the following chart for the corresponding size of the item(s) being bid on.

Largest size item being bid on / Minimum PV Project Size, kW DC
<200 kW / 200 kW
200 to 1000 kW / 1000 kW
>1000 kW / 1000 kW

Have you provided a PV Projectwith a size equal to or greater than the ‘Minimum PV Project Size’ for the largest size item being bid on?

☐ / Yes
☐ / No

PV Project #1

PV Project Name
Size of the PV system (kW, DC)
Year completed
Date PPA was executed
Customer’s Name
Customer’s Contact Name
Customer’s Contact Phone Number
Customer’s Contact email address
Type of Government or Commercial Entity:
☐ / Federal Agency
☐ / State Agency
☐ / Local Municipality (City, Town, County, etc)
☐ / College
☐ / School District
☐ / Commercial Business
☐ / Other – provide description:
Type of System:
☐ / Roof Mounted
☐ / Ground Mounted
☐ / Parking Canopy
☐ / Pole Mounted

Did your company execute a Power Purchase Agreement for this project?

☐ / Yes
☐ / No

What was the term of the Power Purchase Agreement in years?

Years

PV Project #2

PV Project Name
Size of the PV system (kW, DC)
Year completed
Date PPA was executed
Customer’s Name
Customer’s Contact Name
Customer’s Contact Phone Number
Customer’s Contact email address
Type of Government or Commercial Entity:
☐ / Federal Agency
☐ / State Agency
☐ / Local Municipality (City, Town, County, etc)
☐ / College
☐ / School District
☐ / Commercial Business
☐ / Other – provide description:
Type of System:
☐ / Roof Mounted
☐ / Ground Mounted
☐ / Parking Canopy
☐ / Pole Mounted

Did your company execute a Power Purchase Agreement for this project?

☐ / Yes
☐ / No

What was the term of the Power Purchase Agreement in years?

Years

PV Project #3

PV Project Name
Size of the PV system (kW, DC)
Year completed
Date PPA was executed
Customer’s Name
Customer’s Contact Name
Customer’s Contact Phone Number
Customer’s Contact email address
Type of Government or Commercial Entity:
☐ / Federal Agency
☐ / State Agency
☐ / Local Municipality (City, Town, County, etc)
☐ / College
☐ / School District
☐ / Commercial Business
☐ / Other – provide description:
Type of System:
☐ / Roof Mounted
☐ / Ground Mounted
☐ / Parking Canopy
☐ / Pole Mounted

Did your company execute a Power Purchase Agreement for this project?

☐ / Yes
☐ / No

What was the term of the Power Purchase Agreement in years?

Years

PV Project #4

PV Project Name
Size of the PV system (kW, DC)
Year completed
Date PPA was executed
Customer’s Name
Customer’s Contact Name
Customer’s Contact Phone Number
Customer’s Contact email address
Type of Government or Commercial Entity:
☐ / Federal Agency
☐ / State Agency
☐ / Local Municipality (City, Town, County, etc)
☐ / College
☐ / School District
☐ / Commercial Business
☐ / Other – provide description:
Type of System:
☐ / Roof Mounted
☐ / Ground Mounted
☐ / Parking Canopy
☐ / Pole Mounted

Did your company execute a Power Purchase Agreement for this project?

☐ / Yes
☐ / No

What was the term of the Power Purchase Agreement in years?

Years

PV Project #5

PV Project Name
Size of the PV system (kW, DC)
Year completed
Date PPA was executed
Customer’s Name
Customer’s Contact Name
Customer’s Contact Phone Number
Customer’s Contact email address
Type of Government or Commercial Entity:
☐ / Federal Agency
☐ / State Agency
☐ / Local Municipality (City, Town, County, etc)
☐ / College
☐ / School District
☐ / Commercial Business
☐ / Other – provide description:
Type of System:
☐ / Roof Mounted
☐ / Ground Mounted
☐ / Parking Canopy
☐ / Pole Mounted

Did your company execute a Power Purchase Agreement for this project?

☐ / Yes
☐ / No

What was the term of the Power Purchase Agreement in years?

Years

PV Project #6

PV Project Name
Size of the PV system (kW, DC)
Year completed
Date PPA was executed
Customer’s Name
Customer’s Contact Name
Customer’s Contact Phone Number
Customer’s Contact email address
Type of Government or Commercial Entity:
☐ / Federal Agency
☐ / State Agency
☐ / Local Municipality (City, Town, County, etc)
☐ / College
☐ / School District
☐ / Commercial Business
☐ / Other – provide description:
Type of System:
☐ / Roof Mounted
☐ / Ground Mounted
☐ / Parking Canopy
☐ / Pole Mounted

Did your company execute a Power Purchase Agreement for this project?

☐ / Yes
☐ / No

What was the term of the Power Purchase Agreement in years?

Years

PV Project #7

PV Project Name
Size of the PV system (kW, DC)
Year completed
Date PPA was executed
Customer’s Name
Customer’s Contact Name
Customer’s Contact Phone Number
Customer’s Contact email address
Type of Government or Commercial Entity:
☐ / Federal Agency
☐ / State Agency
☐ / Local Municipality (City, Town, County, etc)
☐ / College
☐ / School District
☐ / Commercial Business
☐ / Other – provide description:
Type of System:
☐ / Roof Mounted
☐ / Ground Mounted
☐ / Parking Canopy
☐ / Pole Mounted

Did your company execute a Power Purchase Agreement for this project?

☐ / Yes
☐ / No

What was the term of the Power Purchase Agreement in years?

Years

PV Project #8

PV Project Name
Size of the PV system (kW, DC)
Year completed
Date PPA was executed
Customer’s Name
Customer’s Contact Name
Customer’s Contact Phone Number
Customer’s Contact email address
Type of Government or Commercial Entity:
☐ / Federal Agency
☐ / State Agency
☐ / Local Municipality (City, Town, County, etc)
☐ / College
☐ / School District
☐ / Commercial Business
☐ / Other – provide description:
Type of System:
☐ / Roof Mounted
☐ / Ground Mounted
☐ / Parking Canopy
☐ / Pole Mounted

Did your company execute a Power Purchase Agreement for this project?

☐ / Yes
☐ / No

What was the term of the Power Purchase Agreement in years?

Years

PV Project #9

PV Project Name
Size of the PV system (kW, DC)
Year completed
Date PPA was executed
Customer’s Name
Customer’s Contact Name
Customer’s Contact Phone Number
Customer’s Contact email address
Type of Government or Commercial Entity:
☐ / Federal Agency
☐ / State Agency
☐ / Local Municipality (City, Town, County, etc)
☐ / College
☐ / School District
☐ / Commercial Business
☐ / Other – provide description:
Type of System:
☐ / Roof Mounted
☐ / Ground Mounted
☐ / Parking Canopy
☐ / Pole Mounted

Did your company execute a Power Purchase Agreement for this project?

☐ / Yes
☐ / No

What was the term of the Power Purchase Agreement in years?

Years

PV Project #10

PV Project Name
Size of the PV system (kW, DC)
Year completed
Date PPA was executed
Customer’s Name
Customer’s Contact Name
Customer’s Contact Phone Number
Customer’s Contact email address
Type of Government or Commercial Entity:
☐ / Federal Agency
☐ / State Agency
☐ / Local Municipality (City, Town, County, etc)
☐ / College
☐ / School District
☐ / Commercial Business
☐ / Other – provide description:
Type of System:
☐ / Roof Mounted
☐ / Ground Mounted
☐ / Parking Canopy
☐ / Pole Mounted

Did your company execute a Power Purchase Agreement for this project?

☐ / Yes
☐ / No

What was the term of the Power Purchase Agreement in years?

Years

RFP 23017 Attachment 10 – Minimum Qualifications Submittal Form.docx Revised 11-04-2016